The Nurse Referral form is a great tool for teacher or administrators to use when sending a student to the nurse's office. It facilitates record keeping with the additional copies as well as serves as a pass for readmission to class. In cases where HIPAA regulations need to be met, the teacher copy can be used if removed before nurse fills in nurse's report section, or simply removed prior to sending the child to the nurse. Also see our new 2-part version #440 to meet these needs as well.  Use it with our Privacy Envelope #431 to send confidential communication home to parents.

3 Copies: Parent, Office, Teacher